BACKGROUND: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a potential confounder. METHODS: An observational study was performed in 215 subjects with type 1 diabetes treated with multiple insulin injection therapy. Atherosclerosis was assessed by measurement of carotid intima-media thickness (CIMT). RESULTS: The cumulative dose of regular insulin showed a positive and significant relation with CIMT: increase of 21 microm in CIMT per S.D. of insulin use (95% CI: 8-35 adjusted for gender and age), which remained unchanged after adjustment for duration of diabetes, HbA1c, BMI, pulse pressure, physical activity and carotid lumen diameter. A similar relation was found for intermediate-acting insulin: 15.5 microm per S.D. (2-29), which was no longer present after further adjustment. CONCLUSIONS: These findings provide evidence that a high cumulative dose of regular insulin is a risk factor for atherosclerosis.
BACKGROUND: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a potential confounder. METHODS: An observational study was performed in 215 subjects with type 1 diabetes treated with multiple insulin injection therapy. Atherosclerosis was assessed by measurement of carotid intima-media thickness (CIMT). RESULTS: The cumulative dose of regular insulin showed a positive and significant relation with CIMT: increase of 21 microm in CIMT per S.D. of insulin use (95% CI: 8-35 adjusted for gender and age), which remained unchanged after adjustment for duration of diabetes, HbA1c, BMI, pulse pressure, physical activity and carotid lumen diameter. A similar relation was found for intermediate-acting insulin: 15.5 microm per S.D. (2-29), which was no longer present after further adjustment. CONCLUSIONS: These findings provide evidence that a high cumulative dose of regular insulin is a risk factor for atherosclerosis.
Authors: Rimke C Vos; Mariëlle Jp van Avendonk; Hanneke Jansen; Alexander N Goudswaard; Maureen van den Donk; Kees Gorter; Anneloes Kerssen; Guy Ehm Rutten Journal: Cochrane Database Syst Rev Date: 2016-09-18
Authors: Sameed Ahmed M Khatana; Tracey H Taveira; Andrea G Dooley; Wen-Chih Wu Journal: J Clin Hypertens (Greenwich) Date: 2010-06 Impact factor: 3.738
Authors: Dale S Edgerton; Mary C Moore; Jason J Winnick; Melanie Scott; Ben Farmer; Helle Naver; Claus B Jeppesen; Peter Madsen; Thomas B Kjeldsen; Erica Nishimura; Christian L Brand; Alan D Cherrington Journal: Diabetes Date: 2014-06-19 Impact factor: 9.461